Dr. Gerard M. Nadal: Science in Service of the Pro-Life Movement

How Catholic Bioethics Is Guided

The following article by Father Tad Pacholczyk, Director of Education, National Catholic Bioethics Center, was written a year ago. I reproduce it here to offer more foundation to understanding the dynamics behind the controversy in Phoenix.

Thinking About Moral Absolutes

by Father Tad Pacholczyk, Director of Education, National Catholic Bioethics Center

May 2009. When Pope Benedict XVI visited the United States in April of 2008, I had the chance to attend the opening ceremony at the White House South Lawn. As I listened to President Bush’s welcoming remarks to the Pope, I was caught off guard by one line in particular, a powerful statement that seemed almost too philosophical to be spoken by a United States president: “ In a world where some no longer believe that we can distinguish between simple right and wrong, we need your message to reject this dictatorship of relativism and embrace a culture of justice and truth.”

The President was expressing how we live in a time of history marked by moral relativism. This is the belief that there really is no right and wrong, just your opinion and mine about right and wrong, and we should simply “agree to disagree” and learn to get along. That is to say: you may believe that abortion, same-sex marriage, and embryonic stem cell research are fine, and I may not, but there’s really no point in arguing, since everything is relative anyway – morality is up to me and you to decide individually. In such a view, there are no moral absolutes or universals, and morality shifts freely with each person’s perspective.

Ultimately, however, this position is neither reasonable nor logical.

If morality were merely about your and my moral opinions, the results would be disastrous. If I believe racism against blacks and the institution of slavery built upon it are wrong, but you believe they’re okay, can we both go our merry ways and live according to our own morality? Clearly not, and the United States had to undergo a terrible civil war to address this very question. If I believe serial murder and rape are wrong, but you believe they’re OK, can we both go off and live according to our own positions? Clearly not, since both positions cannot be true.

These obvious examples illustrate what each of us already knows, namely, that in the real world “relative” truth doesn’t work. Suppose you and I each drive towards an intersection with a traffic light. If it were up to you and me to make up our own minds about what color the light is, without any reference to its real color, there would certainly be a lot of accidents at our intersections. What many fail to realize is that the moral world works similarly. Many people’s moral lives are crashing and burning because they fail to respect the non-arbitrary markers of the moral roadmap guiding our human journey. They’ve slipped into thinking that they can make up their own rules as they go along, and that it’s all relative to their own desires or circumstances.

In the movie Schindler’s List, much of the action takes place in a Nazi labor camp. The camp commandant decides to take a young, Jewish girl to be his personal maidservant. At one point in the film, this girl has a private and very disturbing conversation with another man, Oskar Schindler, the protagonist of the film. With deep fear in her voice she says to him, “I know that someday my master will shoot me.” Schindler at first can’t believe what he is hearing, and he does his best to reassure her that the commandant is really quite fond of her. But she insists, “No, someday he will shoot me.” She then speaks of what she had witnessed the previous day. She had seen him walk out of his quarters, draw his gun, and shoot a Jewish woman who was walking by with a bundle in her hand. She described the woman: “Just a woman on her way somewhere. No fatter, or thinner, or slower, or faster than anyone else; and I couldn’t guess what she had done [to provoke him]. The more you see of the commandant, the more you see there are no set rules that you can live by. You can’t say to yourself, ‘If I follow these rules, I will be safe.’”

Fr. Raymond Suriani, commenting on this famous scene from the movie noted how this girl was absolutely correct: In a world of moral confusion, in a world of moral relativism, there can be no safety, and, consequently, no peace. She understood that in the “world” of that Nazi labor camp, right and wrong had been blurred to such an extent, that she couldn’t determine what was “right” even in the mind of the commandant. What pleased him at one moment might not please him in the next. And if he happened to have power, or to have a gun in his hand when he wasn’t pleased, she knew she could easily end up being his next victim.

There are certain important truths and universal moral absolutes which speak powerfully to us as humans about how we must relate to ourselves, to others, and to society. We can draw strength from the prophetic and protective voice of the Church, which speaks tirelessly to us of these moral absolutes and points out the threat to our humanity posed by every agenda of relativism.

Rev. Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, MA, and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia. See http://www.ncbcenter.org

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27 Responses

{Bishop bashing may pass for informed debate on that hate-filled site from you you visit, but it is not acceptable here. Your hate-filled comment was deleted, as it adds nothing substantive to the discussion. As a direction, look to the civility between Dr. Becker and me. Though we have profound disagreement, I have profound respect for the work that she does and her personal conscience, expressed thoughtfully, intelligently and civilly. If you cannot do the same, please refrain from commenting, as your posts will simply be taken down. Thank you. GN.}

I think it’s unfair for you to interpret an entire comment as “bishop bashing” when only the last line referred directly to Bishop Olmsted.

However, to restate it without reference to Bishop Olmsted:

I agree with Father Tad Pacholczyk. We must take a moral stand. We cannot permit the kind of human sacrifice which I have sadly seen advocated in far too many places over the past few days: the idea that doctors, nurses, and hospitals, must be required under threat of excommunication to let some patients die because the Catholic Church mandates death over life.

jesurgislac:
Catholic doctors and nurses MUST adhere to church teaching on bioethics.
If you are a Catholic you either follow the teachings of the faith or you do not.
In that case, you are free to work elsewhere and euthanize people, abort and experiment.
The Catholic church’s teaching is about respecting the dignity of the human person. And in the eyes of the church, the unborn person has equal standing and equal dignity to that of the mother.
The decision in this case by the ethics board at the hospital suggests otherwise.

Catholic doctors and nurses MUST adhere to church teaching on bioethics.

Then they should NOT be working as doctors and nurses anywhere their professional obligations require them to keep patients alive even though church bioethics mandate they should let the patient die.

Catholic doctors and nurses who choose to conform to church bioethics over professional obligationsshouldn’t be working in emergency rooms, or doing any kind of OB/GYN work.

Catholic hospitals which require ALL medical staff, whether or not they’re Catholic, to conform to church bioethics, shouldn’t be taking on girls or women as patients at all, should certainly not have an OB/GYN department, and must not have an emergency room. This situation in Arizona has made clear that church bioethics are in unalterable moral conflict with a doctor’s/nurse’s professional and ethical obligation to do their best for their patients lives and good health.

And in the eyes of the church, the unborn person has equal standing and equal dignity to that of the mother.

I could wish that meant that in the eyes of the church both had an equal right to live, rather than believing both have an equal right to be let die. In the grave everyone is equal, as they say, but the reason the “eyes of the church” can’t be allowed to govern hospital procedure, is that a hospital is required to make choices for life and health – to let one go out alive, rather than send both home in a coffin.

The decision in this case by the ethics board at the hospital suggests otherwise.

I agree. The ethics board at the hospital obviously felt that they both had an equal riight to live. As the unborn child could not live, no matter what choice was made, the church would have condemned the mother to death so she would be equal with her unborn child: the hospital chose to give the mother her equal chance at life.

You have been called out by Pat Goltz on two other threads. What you should know about me is that I have a very short fuse on two issues:

1. Commenters spreading calumny as a means of argumentation, which you have done. Your comments were deleted, not merely edited.

2. Commenters insisting on stating untruth (commonly called lies) after the record has been cleared. That sort of plugging your ears and shouting over people passes for conversation elsewhere, not here. I have blocked others from returning here for doing so, and I’ll do it with you as well. Consider this your last warning.

I’m going to state this one more time with crystal clarity:

The Catholic Church does NOT mandate that anyone dies. YOU DO! You do when you put a gun to a baby’s head and pull the trigger, when it is literally ripped to pieces.

I posted this particular article for a reason, the vignette from Schindler’s list. Contrary to what our senses may tell us, the camp commandant’s behavior was not at all arbitrary. It actually was guided by YOUR logic, expressed here with the same brutality as characterized his actions.

The inmates in the camp were all going to die anyway. Clearly the commandant was consumed by overwhelming anxiety from the burden of carrying that camp, which threatened to overtake him unless that anxiety was relieved. Shooting a prisoner seemed to relieve the stress for a time. Now, inasmuch as those inmates were going to die anyway, it really didn’t matter if they were shot today, tomorrow, or next month. Once the reality of their death is a certitude, it matters not how they are killed in such a moral framework. Bullet. Medical experimentation. Gas chamber. Torn apart by dogs. Hanged.

It’s all the same isn’t it?

We have a very different view. We didn’t create the PHT. We see two humans before us. We say treat both patients. Try to save both. Dr. Becker says kill the baby, the sooner, the better. So do you.

Newsflash Einstein: The stress from the abortion in such a critically ill woman could very well kill her, as Pat Goltz ably points out. We see the baby as having equal moral worth as the mother and refuse to kill it. That isn’t the same as condemning the mother to death. It is an equal fiction that she couldn’t be wheeled to a critical care ambulance and taken by her spouse to a hospital 10 minutes away, where your brutal choice could be exercised. If she is so frail as to probably die en route, then the abortion would absolutely kill her.

In short, you mistake my civility for gullibility. Your having done so repeatedly, I’ll resort to the tone and tenor of that site where your fellow travelers all meet. Cut the crap, or you’re out of here.

I’ll not have your every post repeat calumnies against my Church. If that’s all you’re here for, then get lost.

“Then they should NOT be working as doctors and nurses anywhere their professional obligations require them to keep patients alive even though church bioethics mandate they should let the patient die.”

Excuse me? They were working in a CATHOLIC hospital. The expectation is that CATHOLIC hospitals and their STAFF treat ALL patients with dignity and preserve the inherent God-given right to life.
The baby in this situation was not treated in this manner – he/she was summarily executed.

Your position is one commonly being touted today in attempt to drive Catholic doctors out of the medical field.

“As the unborn child could not live, no matter what choice was made, the church would have condemned the mother to death so she would be equal with her unborn child:”

we will never actually know the truth of this matter….
and sadly there are Catholic hospitals that practice eugenic abortion (the one my son was born in 20 years ago has been doing them for at least that long :( ) and abortion under suspicious circumstances….

“the reason the “eyes of the church” can’t be allowed to govern hospital procedure, is that a hospital is required to make choices for life and health – to let one go out alive, rather than send both home in a coffin.”

What you are implying here is that hospitals do not have values that they adhere to. But you are quite wrong. All hospitals espouse values in the way that they treat patients.
A CATHOLIC hospital’s values are that ALL persons have dignity in the eyes of God and are equal in the right to life. It is morally wrong to kill one patient to save another. You cannot abort a baby to save it’s mother anymore than you can kill the patient in the bed next to the mother to give her a new set of lungs.
A hospital that practices abortion has the value that unborn life is less than those already born. That is a value Catholic medicine is NOT prepared to support.
This is especially so in the area of obstetrics – can’t have any doctors opposing the right of women to kill their babies or who are against prescribing birth control pills to 10 year old girls or anyone for that matter. But I digress.

If you work in a Catholic institution, you should be prepared to live your life according to Catholic beliefs. If you aren’t prepared to do so, there are plenty of other opportunities to work elsewhere.

Of course they do: where an abortion would save a pregnant woman’s life, as was the case in Phoenix, you, and other Catholics, have made crystal clear that in such a case the Catholic Church mandates that the woman must die.

Comparing patients unfortunate enough to be in a Catholic Hospital ER to inmates in a concentration camp is telling, but not really germane to the issue.

The stress from the abortion in such a critically ill woman could very well kill her

Well, there are two responses to that: One, she was about to die. If an abortion was stressful enough to cause her death, for which there is no evidence, it was also her only chance of life. Two: demonstrably, the abortion was her only chance of life, and she lived, even though the Catholic Church has since bestirred itself and declared that she should have been left to die.

I’ll not have your every post repeat calumnies against my Church. If that’s all you’re here for, then get lost.

Calumnies? You have posted about 87 times on abortion. I haven’t obviously read all of your posts, but in every single one I have read, you repeat what I have come to accept over the past distressing few days: the Catholic Church requires that women shall die if their lives can only be saved by an abortion. I was prepared to accept, this time last week, that the Catholic Church held that it was permissible for women to be allowed to live if the only means of saving their life was to perform an abortion: you have succeeded in convincing me that this is not so. If you think this is a calumny on your Church, perhaps you shouldn’t have been so eloquent in advocating it.

Mary Catherine, I apologize for not responding to your comment, but Gerard objects to my plain speaking about the effect his posts on abortion and the Catholic Church have had on my beliefs, and I suspect he is about to delete, then ban me.

I’ve been over to your neck of the woods and seen how my polite commentary has been treated. All I can say is that you need to check your muddy boots at my door. What I traffic in here is truth (not conjecture); the truth of science through linking to mainstream data. I also deal in the truth of Catholic theology, dogma, doctrine, and Canon Law. Once corrected in their errors about what we believe and teach, I expect visitors to proceed in light of the truth that has been presented.

This site is not a place for people who hate the Catholic Church to come and defecate. There’s more than enough of that on the site where you come from. I expect reasoned debate and mutual respect. Not everyone is capable of that. There are plenty of sewers for such individuals.

If you wish to explore the rationale that imbues Catholic biomedical ethics, you are more than welcome here. If you came to throw bombs, you are not welcome here.

The faeces that you have spoken here is not the truth. I’ve since corrected your mistaken impression of what specifically is Catholic teaching regarding this matter. Anti-Catholicism may be one of the last acceptable bigotries, but here it is not welcome. If you cannot allow yourself to be corrected in your erroneous assumptions and conclusions, then yes, there is no place for you here.

Of course they do: where an abortion would save a pregnant woman’s life, as was the case in Phoenix, you, and other Catholics, have made crystal clear that in such a case the Catholic Church mandates that the woman must die.”

Wrong. The Catholic church Mandates that all persons are created in the image of God and therefore must be treated with dignity – this includes the unborn.
The Catholic church Mandates that you CANNOT commit an immoral act (the deliberate murder of an unborn child) to achieve a good end (saving the life of the mother).

I am tiring of having to to follow across several threads as you continue to take what I say out of context while refusing to answer simple questions I pose.

From your earlier comments in this thread:
“We have a very different view. We didn’t create the PHT. We see two humans before us. We say treat both patients. Try to save both. Dr. Becker says kill the baby, the sooner, the better. So do you.”

The above sentence infers that I would destroy a fetus instead of trying to treat the mother in another fashion but that is (And I am beginning to get the impression that it is purposeful) twisting what I have said. In a tertiary care hospital, particularly a Catholic one, I think you can rest assured that for a critical patient all treatment options were being taken including maximal medical management. Since you are a PhD and not an MD, I have to wonder how much exposure to clinical Medical ethics committees you have had. Where ever I have worked, the Ethics committee is called in the case of a seriously ill patient where time is of the essence in the patients care and the conclusion the medical team is coming to is very troubling to them. All of those who have commented on this blog (most if not all of whom have demonstrated that they have little professional contact with critical care medicine) seem to think we take those decisions very lightly and without a moral compass…..if that were true, you would see a lot more death in and out of hospitals, you would see much poorer outcomes, and if it were easy to allow patients to die, we would not be having this discussion because in reality the overwhelmingly easier choice would have been to NOT abort this fetus and let nature take it’s course. Keeping a critically ill patient with pulmonary hypertension alive as a very labor intensive process where very often you can’t win for losing

You follow that paragraph with:
“Newsflash Einstein:”
Not a great way to lead by example

“The stress from the abortion in such a critically ill woman could very well kill her, as Pat Goltz ably points out.”
I am not sure where you are drawing your statistics, but an early gestation termination is actually less dangerous than carrying any pregnancy to term. The Maternal mortality in this day and age associated with pregnancy is 3.3/100,000 (as of 2003 which is the last time the CDC listed the statistic). The maternal mortality rate for an early pregnancy termination is 1/1,000,000 (Guttmacher)….Now with a mother who has severe PAH, the real risk of EITHER carrying the pregnancy OR aborting would be significantly higher than the normal population BUT the risk of terminating the pregnancy at 11 weeks even compared with 16 weeks is quite a bit lower AND Because at 11 weeks we are not talking about true Labor with the termination, the risk of sudden death is significantly lower with the abortion than it would be with delivering a viable child at any point later. I think this is supported by the fact that this mother did not die though she had been too critical to move when the termination was done.

You go on to say: “We see the baby as having equal moral worth as the mother and refuse to kill it. That isn’t the same as condemning the mother to death. It is an equal fiction that she couldn’t be wheeled to a critical care ambulance and taken by her spouse to a hospital 10 minutes away, where your brutal choice could be exercised. If she is so frail as to probably die en route, then the abortion would absolutely kill her.” and further down in the comments you say: “What I traffic in here is truth (not conjecture)”

But YOU are dealing in conjecture rather than truth….let’s be frank. NONE of us knows the specifics of what went on for this mother so how could you possibly know that this mother was not too ill and unstable to be moved? And how could you (I will wager you have never treated a patient with severe PAH and Right Heart Failure) possible be so sure that if she could not be moved, she would have died with an early gestation pregnancy termination? This is a VERY different procedure from a late term abortion.

Also, since I am getting dragged in this discussion from one string to another, can you please answer my questions:

1- As I asked in the other posts, you suggested “Other of your colleagues would beg to differ with you on this approach to the management of both patient’s lives.” I have to ask if those are physicians who have cared directly for patients with Pulmonary hypertension in this situation?

2 – In the rare BUT still experienced medical situation where there is a CLEAR CHOICE of loosing 2 lives or saving one …no other choice possible, is it acceptable to lose both lives. Yes or No?

3 – If an ethics committee is purely cover for an unacceptable decision, why have an ethics committee in the first place? If all medical care is black and white to the church, and if there is a clear dogma to be followed, why does any Catholic hospital have an ethics committee?

4 – You indicate in one of the strings that “This same group has engaged in a slow, selective leak of information to carefully craft a narrative wherein they are the heroes. Along the way they have essentially betrayed this woman’s identity by divulging her age, month of admission, pregnancy, condition, and course of action.” If this is true, regardless of the circumstance, you have a HIPPA violation as you mention. Has anyone sought to bring the hospital up on charges? Do you have data to support your charges or is this also conjecture?

5 – and now from my comments above there are two more questions:
How could you possibly know that this mother was not too ill and unstable to be moved? And how could you (I will wager you have never treated a patient with severe PAH and Right Heart Failure) possible be so sure that if she could not be moved, she would have died with an early gestation pregnancy termination?

Dr Nadal my list of questions is steadily growing and I would love to have some straight answers without conjecture.

“How could you possibly know that this mother was not too ill and unstable to be moved? And how could you (I will wager you have never treated a patient with severe PAH and Right Heart Failure) possible be so sure that if she could not be moved, she would have died with an early gestation pregnancy termination?”

Unfortunately, we don’t know anything really about the patient’s illness and it’s severity.

We only know what the hospital has released Dr. Becker.

But that is a crucial point here.

Given the way the medical establishment considers “fetuses” these days, they generally are given the short end of the stick when it comes to health care. We have “fetuses” who are routinely denied care for minor genetic problems and we have “fetuses” who are killed for such defects while in the womb.
We all know or have heard of situations where doctors routinely overstate the situation and recommend abortion.
This is pretty much standard obstetric care these days. Doctors telling women that life with their baby will be hell. That the baby will be a ‘vegetable’. That a pregnancy will kill a mother. Even that they should abort a baby who will live on minutes or hours after birth.

I know of a mom who was told that she must abort because she and everyone in her household had fifth disease. Yet she had a completely healthy baby. Her doctor was insistent upon the abortion and she left his care.

Doctors refusing patient care unless the mother undergoes amnio – I personally know of a situation where this happened to a woman pregnant with twins and she was age 35. Why would a doctor force a woman to undergo amnio unless he was prepared to recommend abortion.

The way a doctor approaches a problem can have a far-reaching effect on how a woman and her family will deal with a crisis and even whether or not they will continue a pregnancy.
Many doctors are only too willing to play the death card in order to … what? Save health care dollars? For eugenic reasons…? Because they believe that abortion is a solution to many problems. I simply don’t know.

I have no idea where you live, but if what you claim above is your first person experience and not what you’ve heard in the media or on the net, you need to find yourself another hospital to deal with. As I have mentioned before, I have more than 20 years experience in my field and I AM a fetal cardiologist. Fetuses are NOT neglected and in fact there is a whole cadre of specialty physicians who train to care for the fetus. Patient care is MOST expensive at the age extremes (the very young, or prenates and the very old). Even so, fetuses, premature infants and children in general have far easier access and far more complete health care than just about anyone else in society with the possible exception of the very wealthy. And that is because we are a society as a whole that believes in the promise and potential of the young. I have worked in 6 different health care systems over the course of my training and career and I have NEVER run across the kind of disregard you claim is a regular occurrence. Please tell me which health care systems you encounter this in.

To say “fetuses are denied care for minor genetic problems”…..you need not to speak in generalities but give me specifics we can discuss. There are many genetic abnormalities we cannot safely address prenatally. In my own field I see fetuses from about 16 weeks on many of whom have serious congenital cardiac abnormalities. Some of these will cause demise of the child before birth, in some cases the parents choose to terminate the pregnancy because they can not bare the suffering they expect for their child over it’s life time, and other will carry their pregnancy to as close to term as possible and ask that all be done for the child. I and my colleagues (again where I have practiced) DO NOT MAKE THIS DECISION FOR THEM. We give them information, we send them to cardiac websites where they can read about the same in someone elses words. I always offer to put them in touch with families raising children with the same of similar defects and I always encourage them to talk with their family and with their clergy if they identify themselves with a particular church, synagogue or mosque. Even when they ask me to help them make their decision, I tell them I won’t have to live with the consequences and so I will not. BUT I Promise you, and I affirm for them that this is the ugliest and hardest decision they will every make in their lives. If you have not been in this position you can not know how harrowing the experience is that these parents go through. None of my patients takes the information or the choice they make lightly.

You also mention Amniocenteses. The way I approach that is as follows (particularly since it does have a small but real risk of causing a miscarriage):
I obtain an ultrasound of the fetus (that is usually what they come to me for in the first place). If I find an abnormality that has a high association with a chromosomal syndrome, I bring that to the parents attention and give them all the information I can about the heart defect and about the syndrome. as mentioned above I encourage them to gather as much information as possible after we finish. Then after this whole discussion I tell them the choice of how to proceed is theirs. If they plan to carry the pregnancy no matter what is found, I advise them that there is no need of an amniocentesis as it won’t change anything. If the amnio might provide information that would make their minds up about how they want to proceed, then I do recommend it. I never require any test in order to care for the mother or fetus. I will however let them know what will be missing without that information. as I mentioned above, in all the institutions I have practiced in, this was standard operating procedure. From my comments you will correctly recognize that I am pro choice. In my line of work though most of my patients choose to carry the pregnancy regardless, I feel it is very important and empowering for them to be able to say that keeping their child was not imposed on them but was something they wanted…think about that.

“I have no idea where you live, but if what you claim above is your first person experience and not what you’ve heard in the media or on the net, you need to find yourself another hospital to deal with.”

Fortunately I no longer live near this hospital. But I was induced by my ob/gyn who did a “cervical sweep” against my knowledge and without my consent because HE believed that my baby was too large (I’m petite). He never bothered to tell me about this. I found out 2 years later when I was pregnant with my second baby.

“Some of these will cause demise of the child before birth, in some cases the parents choose to terminate the pregnancy because they can not bare the suffering they expect for their child over it’s life time, and other will carry their pregnancy to as close to term as possible and ask that all be done for the child. I and my colleagues (again where I have practiced) DO NOT MAKE THIS DECISION FOR THEM.”

Yes of course YOU don’t MAKE the decision for them.
But for many couples, their doctor’s take on serious genetic defects will directly impact the decision they make – whether to abort or not. And there are stories throughout the media on couples whose situations were present by their doctor in such as way that the “responsible” course of action would be to abort these babies. Many doctors see no merit to carrying a “defective” baby to term – one who will die shortly thereafter.

“…to terminate the pregnancy because they can not bare the suffering they expect for their child over it’s life time”

I really love this euphemism for abortion! Couples terminate (abort) the pregnancy (the baby) because THEY cannot bare the suffering THEY EXPECT for their child over it’s lifetime.
Do you not see Dr. Becker how YOUR words can affect a couple?
Do you see how you dehumanize the child and soften what you are asking/suggesting to your patients?
Abortion becomes terminating.
A baby becomes “the pregnancy”
And never mind the fact that YOU cannot for certain, determine the EXACT quality of life that child will have for even one minute of his/her life.
You are suggesting that couples abort these babies based on the suffering THEY EXPECT.

Where does this expectation come from?

You cannot deny that this is done routinely now for children with Down Syndrome.

“From my comments you will correctly recognize that I am pro choice.” :( Unfortunate, since I do not see the killing of a baby as much of a choice…..
It used to be that doctors did no harm, Dr. Becker…..

As for the ultra-sound situation, the young woman in question was 35 years old and the doctor she was seeing told her that ALL his patients were required to have an amnio at this age due to the possibility of genetic defects. Ultimately, she chose to have the test done. As far as I”m concerned this was medical malpractice.

Dr. Becker I don’t want to detract from the overall discussion at hand, but quite honestly, as the mother of 4 children, the medical profession is NOT respectful of women and treating them in a way that is understanding of their bodies.
Pregnancy is a disease.
Menstrual periods are something to be removed with birth control pills.
Childbirth is induced, drugged.
Menopause is treated with hormones.
Even breastfeeding is rarely understood by doctors.
I have been lucky. I found myself a prolife doctor who had 8 children, and understood how a woman’s body works naturally. My last child was born at home – a far cry from the situation where the ob didn’t respect me

jesurgislac: I am really sick of reading the way you TWIST the Roman church’s stand on pregnant mothers. The statement that the Roman church mandates death over life, is an outright LIE, and absolutely NOT the truth, so quit mislabeling it! I don’t have a lot of use for the Roman church over a lot of issues, but LYING about an organization’s stance is intolerable to me. I think Dr. Nadal ought to ban you. I’m sick of reading your messages. And yes, I have read some of the sites where this kind of twisting is the norm, and they make me feel even more nauseous. People who can’t come up with a logical argument often resort to ad hominems and twisting the position of others. The latter is called a Straw Man argument. Construct an idea out of thin air, attribute it to your opponent, and then denounce it. CUT IT OUT!

To several: We don’t KNOW that having an abortion was that woman’s only chance at life. She may well have survived without one, in which case, it was totally unnecessary. The fact she did survive tends to tell me she didn’t really need an abortion, since abortion is so dangerous for the mother!

Dr. Becker: Your information about the “safety” of early gestation termination is flat-out wrong. Its error comes from a number of different facts. First, most abortion deaths are REPORTED as due to the COMPLICATION rather than abortion. This is partly the fault of the way the coding system is currently implemented. But the complication would never have happened without the abortion, so it’s really an abortion death. That’s only the start. There are plenty of other reasons why abortion deaths are under-reported. Now use a bit of logic here. A woman’s cervix is forced open, causing many tears in the cervix. Her uterus is scraped with a sharp knife, and the placenta must be cut away. The danger of perforation is very real. A woman can bleed to death from that. How much bleeding can a woman who has PHT endure before THAT kills her? And that’s just the beginning. What about possible infection? What about reaction to the anesthesia. What about the possibility they don’t give any because of the danger, and she squirms, and she is injured? What about the possibility that the abortion isn’t completed? There are so many ways an abortion can kill a woman. The mere fact that the Guttmacher Institute has seen fit to LIE about the mortality and morbidity of abortion doesn’t mean you should trust anything they say. The main point is, abortion is a terribly traumatic experience for any woman, a DEEP invasion of her body, and it is simple logic to understand that this puts the woman more at risk than leaving things alone. And as Dr. Nidal has pointed out, the woman’s body doesn’t just suddenly revert to the pre-pregnant state. You said that you treated one woman who first had an abortion, and then her heart valve or artery (I forget which) was replaced, and now she has a normal heart. Why not do the operation on the heart FIRST? Why waste the time doing an abortion? I recognize that you are conscientious within your own philosophy of ethics, but what you have said is, to ME, a prime example of the way in which accepting abortion warps a doctor’s judgment. Sorry, but that’s really how I see it!

Please give this some serious thought, Dr. Becker. It makes no sense to me whatsoever to assert that the kind of deep and traumatic invasion of a woman’s body that first trimester abortion represents is “safer” for her than allowing the pregnancy to continue for the time being and treating her real problem instead. Seriously. Why waste time on the abortion? If she cannot endure birth, worry about that when birth approaches. Do a Caesarian if you have to. Sure, Caesarians are dangerous. But there are times when they are preferable (though they be few and far between). Sure, abortion is more dangerous the later it is done, but you know what? Early birth is safer than abortion anyway. People who do abortions instead of inducing early labor are also generating unnecessary risk for the mother. In the final analysis, your cost-accounting is messed up by statistics that LIE about the safety of first-trimester abortion. Please do some research. The whole story is not being told. And don’t discount a source simply because the source believes abortion is wrong or ill-advised. Some people reach that position BECAUSE of what abortion does to a woman. These sources are based on the MEDICAL literature, and the original information comes from people of every political persuasion.

You also don’t need to be “pro-choice” in order to do an abortion to save a woman’s life. People who do this weren’t being prosecuted, and they wouldn’t be prosecuted now. It’s also poor cost-accounting to say that 52 million UNNECESSARY abortions is preferable to an occasional situation where a woman MIGHT die without one. And before we leave this topic, consider this: 64% of women who have abortions report coercion. So where’s the choice? If you want to be consistent, be vocal about a woman’s right to REFUSE an abortion. This should be protected by law. Why isn’t it?

In re: “I know of a mom who was told that she must abort because she and everyone in her household had fifth disease. Yet she had a completely healthy baby. Her doctor was insistent upon the abortion and she left his care.”

If only more women would do this! We would stop having the problem real quicklike. I BLAME the medical profession for TOLERATING abortionist BUTCHERS in their midst. Any pro-life person who is willing to go to a doctor who accepts abortion is PART OF THE PROBLEM. And any doctor who is willing to tolerate abortionists among their ranks is PART OF THE PROBLEM. For the record, I was once TOLD by someone (a stranger at the time) that I needed surgery or I might die. That person was an abortionist. I refused, and I’m here to tell you about it. And you know what else? I had already TOLD my doctor that I would NEVER work with any doctor who found abortion ACCEPTABLE, let alone did them. After this incident, I asked my doctor why he referred me to an abortionist. He said, “He was the only one who could do the procedure.” And I said, “As far as I am concerned, he doesn’t exist.” And I never went back to that doctor.

Doctors, clean your own house. Get rid of the butchers. Don’t expect us to trust you until you do.

My case is evidence that the idea that an abortion is needed to save a woman’s life is not always true. Doctors are way too quick to assert this position. I want none of it.

“If that’s a lie, and a mislabelling of the Roman Catholic Church’s position, you need to lecture the Catholics – including Gerard Nadal at this blog – who have said that the Catholic Church requires two deaths instead of one life saved.”

No that’s not what he said and NOT what the Church teaches.
The church teaches that there are TWO patients of equal standing and that ought to save BOTH patients.
But that they may not kill one patient to save another.

Your labelling that the Roman church mandates death over life is your own misunderstanding (whether deliberate or not, only God will know), misinterpretation or anti-Catholic bias….

Let’s sink roots on this thread. I must confess that I have taken my time in answering your questions because you are increasingly lacing your commentary with a condescension that seems to emerge when pro-choicers begin to lose ground in an argument. The answers to your 5 questions as listed above:

1. No.

2. There is such a thing as asking the wrong question. This one is predicated on your already having arrogated to yourself the power to murder one of your patients in an attempt to help the other live. More enlightened people call it “playing God”.

3. I never said that all medical care is black and white to the Church. You in your arrogance have said that. This matter of tearing apart babies, however, is black and white.

4. Whether anyone seeks to bring the hospital up on charges is beyond the purview of this blog or discussion. It’s scummy behavior.

5a. How are you so certain that she was too frail to endure a five minute ride in an ICU ambulance to another facility? And if she were, how could she have endured the stress of an abortion?

5b. This was a beauty on your part:

“And how could you (I will wager you have never treated a patient with severe PAH and Right Heart Failure) possible be so sure that if she could not be moved, she would have died with an early gestation pregnancy termination?”

Wow! Would you really wager that a Ph.D. never cared for a patient with PAH? There is your arrogant condescension again.

You seem to miss the point here, because you are firmly wedded to a baby being torn apart one limb at a time.

We aren’t.

As we practice medicine in the Catholic Church, we expressly forbid physicians employed by our hospitals from aborting babies. We do not arrogate the power of God in pointing the finger to mark who lives and who dies. One needn’t be an MD or a PhD to grasp that. An MD or a PhD does not make one smarter or wiser than God. Those degrees certainly do not dispense one from the obligations to moral law.

I take it from your Jewish apologia in other comments that you were shaped by a Jewish culture that is permissive as regards abortion. While we regard the Jews as “Our elder brothers in faith”, as Pope John Paul II used to say, we are not bound by your interpretation of moral norms, especially your isegetic approach to scripture as regards abortion. This is Catholic bioethics being discussed here. Other traditions have no standing in determining moral norms defined by the Magisterium.

As for twisting your words, the challenge is for you to show me how I have done so. I promise you I have not, and have a cut and paste ready to go.

If you want a conversation Dr. Becker, cut it with the air of superiority because you have treated three cases in 20 years. We approach bioethics in the Church with certain immutable principles. These are there to guide clinicians in the moment of crisis. They are also there as a comfort to those of us who wish to be cared for in a facility where a pediatric cardiologist would never say:

“2 – An abortion early in the pregnancy of a patient like this is far safer than taking a wait and see attitude.”

My wife (A NICU/PICU nurse for 20 years) and I would want a physician who would be aggressive in saving our baby, a physician for whom abortion is not an option. Catholic hospitals are just such places for people such as ourselves.

Sr. McBride failed miserably by arrogating power that was not hers to assume. For her efforts, she has automatically incurred excommunication, and knew the penalty in advance.

There is a lot of loud talk and not much humility here. This clouds the real discussion and the need for clarity on the issue. Moral reasoning only progresses if the presentation of arguments can be heard, and the reasoning is not too far removed from where people are. A respectful tone is very helpful.

Situation: A mother has PHT and comes in to the hospital at 11 weeks gestation, gravely ill. She will not survive to 17 weeks. She might survive to 16 weeks. She is going to die soon, and her death will cause the death of the baby. The baby won’t be able to live even if delivered by c-section. The doctor chooses to do nothing, because double-effect doesn’t absolve in this situation. Wrong organ gets ill.

Choosing to do nothing is choosing a death watch. Just because the choice is to do nothing doesn’t mean something hasn’t been chosen. I wish there was another name for it, but in this choice is a choice to watch and wait for death even though at the same time there is affirmation of equal status of mother and child’s right to life.

Other choice. Plan to deliver the baby through c-section when the mother’s condition reaches a certain point, but when she is as far into the pregnancy as possible. Do everything possible to save the baby by prolonging the pregnancy. When she reaches that critical point, do heroic measures to save the baby through c-section and the mom using whatever means necessary. There is no intention for the death of infant or mother. The intention is to save both lives.

I agree with an earlier post by Dr. Nadal; it is through reasoning ahead of time, before the moral dilemmas present themselves, that moral decisions can be best implemented in the hospital. That is why there are ethics panels and IRBs; to reason through cases to make the best decisions possible on current cases and those to come later.

Yes, people die. But if the couple wish to pursue abortion, there are any number of facilities within a 1.5 mile radius where they can have a physician perform the deed. I’m well-acquainted with ethics panels and IRB’s. Their role is to begin with well-established moral and ethical norms to guide them in how to proceed. The job of an ethics board in a Catholic hospital is NOT to explore ways of convincing ourselves that murdering a baby could ever be morally or ethically licit.

Again, the husband need only take his wife by ICU ambulance to any of those other facilities where abortions are performed. They would be there within five minutes.

You say:

“Choosing to do nothing is choosing a death watch.”

And what do you suppose happens during an abortion? You lose sight of the fact that there are two human beings of equal moral worth here. The physician is not responsible for life prevailing at all costs. Not in our ethical framework. Not if that means tearing apart a baby one limb at a time.

“Other choice. Plan to deliver the baby through c-section when the mother’s condition reaches a certain point, but when she is as far into the pregnancy as possible. Do everything possible to save the baby by prolonging the pregnancy. When she reaches that critical point, do heroic measures to save the baby through c-section and the mom using whatever means necessary. There is no intention for the death of infant or mother. The intention is to save both lives.”

[…] In, More Debate on the Phoenix Abortion, More Debate With Dr. Becker on the Phoenix Abortion, How Catholic Bioethics is Guided, and The Principle of Double Effect. I’ve devoted a lot of space here to Gerard Nadal’s […]

Actually, that IS the responsibility of a physician. The whole point of physicians is to treat illness to preserve, and hopefully improve quality of, the life of their patients, and to use any means legally available to them to do so. The business of medicine is universal, and is dictated by industry standards. If Catholics choose to run a business of medicine, then they have to be prepared to comply with the standards of the industry. They cannot pick and choose which procedures they want to perform, just like a vegetarian cannot get a job as a cook and later refuse to cook anything on the menu that includes meat and expect to be accomodated for. If you are not prepared to fufill your duties in an emergancy setting, which may include performing an abortion, then you have no place in that field of medicine. A doctor’s personal beliefs don’t trump the life of a dying patient.

Panda: The whole point of physicians is to treat illness to preserve, and hopefully improve quality of, the life of their patients, and to use any means legally available to them to do so. The business of medicine is universal, and is dictated by industry standards. If Catholics choose to run a business of medicine, then they have to be prepared to comply with the standards of the industry.

My response: Ouch! Your argument is so full of holes it’s not funny. To use any means “legally” available? How about ETHICAL considerations? Industry standards? Heck, involuntary experimentation on Aryan Germans followed by murder was industry standard in Nazi Germany. If industry standards require that a woman be raped with medical instruments if her “doctor” so dictates, and her child hacked to pieces, then industry standards NEED TO CHANGE.

What part of “mass axe-murder” don’t you people understand? That’s exactly what legal abortion is!

Actually, that IS the responsibility of a physician. The whole point of physicians is to treat illness to preserve, and hopefully improve quality of, the life of their patients, and to use any means legally available to them to do so.”

Actually, not necessarily so.
The Catholic church does not require that heroic measures be taken to prolong the life of someone who is dying and for whom those measures will cause undue suffering.

Before you jump all over me, let me say as an example, that if a person is frail and elderly and discovers they have cancer for example, it IS permissible for that person to refuse treatment for the condition if they feel that they cannot withstand the treatments. This is not suicide or exercising a right to die. A doctor is under NO obligation to preserve their life at any cost.

Doctors must also weigh whether the treatment will be of benefit to the patient. Unfortunately today, certain things like water and food are considered “treatment”.